Pain research & management · 2026
Efficacy and Safety of Selective Extracranial Radiofrequency Thermocoagulation and Percutaneous Balloon Compression for V3 Trigeminal Neuralgia.
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Li Hongbo, Shi Jiayue, Xiao Chenxuan, Yi Yu, Xie Keyue
Аннотация
BACKGROUND: Trigeminal neuralgia (TN) is a neuropathic disorder causing paroxysmal severe facial pain. Radiofrequency thermocoagulation (RFTA) and percutaneous balloon compression (PBC) are standard surgical treatments. While RFTA is constrained by its lack of branch selectivity and the risks of repeated intracranial punctures, selective extracranial RFTA (SRFTA) has attracted attention due to its high targeting specificity and fewer neural complications. This study aims to compare the efficacy and safety of SRFTA and PBC in patients with idiopathic TN involving the V3 branch (TN V3).
METHODS: This retrospective study included patients with TN V3 who underwent SRFTA or PBC at the First Affiliated Hospital of Jiaxing University between January, 2019 and May 2024. The primary outcome was the proportion of responders at 1 year. Secondary outcomes included the recurrence rate at 1 year, the numeric rating scale (NRS) score at 1 year, and complications such as facial numbness and masticatory muscle weakness.
RESULTS: A total of 236 patients with TN V3 were included. In both the overall cohort and the propensity score-matched (PSM) cohort, there were no statistically significant differences between the PBC and SRFTA groups in the proportion of responders (overall: 72.7% vs. 77.4%, p = 0.499; PSM: 74.5% vs. 77.5%, p = 0.743), recurrence rate (overall: 19.0% vs. 18.3%, p = 1.000; PSM: 17.6% vs. 17.6%, p = 1.000), and incidence of facial numbness (overall: 62.0% vs. 69.6%, p = 0.276; PSM: 61.8% vs. 70.6%, p = 0.236). However, the incidence of masticatory muscle weakness was significantly higher in the SRFTA group than the PBC group (overall: 12.2% vs. 2.5%, p = 0.009; PSM: 11.8% vs. 2.0%, p = 0.013). Results from the inverse probability of treatment weighting (IPTW) analysis and subgroup analyses were consistent.
CONCLUSION: Within the 1-year follow-up period, both SRFTA and PBC appeared to be effective therapeutic options for patients with TN V3. However, SRFTA was associated with a higher risk of masticatory muscle weakness. Therefore, PBC may be considered preferentially when minimizing motor complications is clinically important.
METHODS: This retrospective study included patients with TN V3 who underwent SRFTA or PBC at the First Affiliated Hospital of Jiaxing University between January, 2019 and May 2024. The primary outcome was the proportion of responders at 1 year. Secondary outcomes included the recurrence rate at 1 year, the numeric rating scale (NRS) score at 1 year, and complications such as facial numbness and masticatory muscle weakness.
RESULTS: A total of 236 patients with TN V3 were included. In both the overall cohort and the propensity score-matched (PSM) cohort, there were no statistically significant differences between the PBC and SRFTA groups in the proportion of responders (overall: 72.7% vs. 77.4%, p = 0.499; PSM: 74.5% vs. 77.5%, p = 0.743), recurrence rate (overall: 19.0% vs. 18.3%, p = 1.000; PSM: 17.6% vs. 17.6%, p = 1.000), and incidence of facial numbness (overall: 62.0% vs. 69.6%, p = 0.276; PSM: 61.8% vs. 70.6%, p = 0.236). However, the incidence of masticatory muscle weakness was significantly higher in the SRFTA group than the PBC group (overall: 12.2% vs. 2.5%, p = 0.009; PSM: 11.8% vs. 2.0%, p = 0.013). Results from the inverse probability of treatment weighting (IPTW) analysis and subgroup analyses were consistent.
CONCLUSION: Within the 1-year follow-up period, both SRFTA and PBC appeared to be effective therapeutic options for patients with TN V3. However, SRFTA was associated with a higher risk of masticatory muscle weakness. Therefore, PBC may be considered preferentially when minimizing motor complications is clinically important.